Provider Demographics
NPI:1437555380
Name:ARAGON, NICHOLETTE LYNNE (MS, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:NICHOLETTE
Middle Name:LYNNE
Last Name:ARAGON
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 W HARMONT DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-5641
Mailing Address - Country:US
Mailing Address - Phone:602-284-3344
Mailing Address - Fax:
Practice Address - Street 1:711 E MISSOURI AVE
Practice Address - Street 2:200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2841
Practice Address - Country:US
Practice Address - Phone:602-234-3733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT-10365106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist